腱板付着部の動脈供給：解剖学的研究

Background: The vascularity of the rotator cuff and its relationship to degenerative tears remains controversial. This study aimed to investigate the arterial supply to the tendinous insertions of the rotator cuff using anatomical dissection and injection techniques. Methods: Fifteen cadaveric shoulders were studied using latex injection and clearing techniques. The contributions of the anterior humeral circumflex artery (AHCA), posterior humeral circumflex artery (PCHA), and suprascapular artery to the rotator cuff insertions were mapped. Results: The critical zone of the supraspinatus tendon (1 cm proximal to insertion) showed relative avascularity supplied primarily by the AHCA ascending branch. The PCHA contributed to the posterior rotator cuff (infraspinatus, teres minor). The suprascapular artery supplied the supraspinatus and infraspinatus from the deep surface. Conclusions: The relative avascularity of the supraspinatus critical zone, dependent on AHCA supply, explains the predilection for degenerative tears at this location.